AOPA’s Medicare lawsuit dismissed

The American Orthotic & Prosthetic Association’s lawsuit against the Department of Health and Human Services and the CMS has been dismissed.

U.S. District Court for the District of Columbia Chief Justice Royce Lamberth granted a motion to dismiss to the U.S. Department of Justice in defense of CMS based on the court’s finding that “AOPA has failed to establish that the court has jurisdiction over its claims.” The American Orthotic & Prosthetic Association (AOPA) filed the suit in May 2013, and the Department of Justice (DOJ) filed for a motion to dismiss in July 2013 based on the claim that the U.S. District Court did not have jurisdiction to hear and decide the lawsuit and that AOPA had not exhausted all of its administrative remedies within the Medicare system, failing to meet the requirements for anyone who wants to sue Medicare.

“AOPA is disappointed with the decision of the District Court, and is still weighing its options in terms of possible appeal,” Thomas F. Fise, AOPA executive director, said in an AOPA statement on the ruling. “While the court dismissed AOPA’s suit largely on technical grounds, AOPA believes the suit was necessary to stand firm for the principle that Medicare cannot take shortcuts with the proper administrative procedures when it is changing rules about what patients are entitled to and how it will determine payments.”

Fise noted that more than 100 O&P businesses have closed since the lawsuit was filed and said AOPA’s hope in filing the lawsuit was “to address the threat to the availability of prosthetic devices resulting from the abrupt August 2011 change in the federal government’s reimbursement rules,” referring to the “Dear Physician” letter distributed by Medicare regarding the documentation of artificial limbs.

Fise added, “AOPA will continue to use all available tools, including advocacy in the legislative, regulatory and judicial sectors to restore fairness for our member health care professionals and the Medicare amputees they serve.”